Legal Claims Analyst (Los Angeles, CA area) MorleyLegal Claims Analyst (Los Angeles, CA area)Los Angeles, CaliforniaRemote$65,000–$77,000 / yearFull timeOffer timely and accurate solutions through inbound and outbound conversations (including phone calls, chats, emails and other communications as needed) while keeping a positive and upbeat attitude. As a Legal Claims Analyst at Morley, you'll play a key role in managing small automotive claims cases, collaborating closely with the General Counsel of a Fortune 500 automaker.
Claims Delegations Oversight Specialist MedPOINT ManagementClaims Delegations Oversight SpecialistSherman Oaks, CARemoteFull timeMedPOINT Management is a leading Independent Practice Association (IPA) management company serving the greater Los Angeles area, with decades of experience supporting physician organizations and health plan partnerships. Our clients trust us for our deep expertise in managed care operations, and our employees value the collaborative, mission-driven culture we've built.
NewMajor Case Unit Claims Adjuster, Commercial Auto ReservMajor Case Unit Claims Adjuster, Commercial AutoCAWe are seeking an experienced and proactive Major Case Claims Resolution Specialist to oversee high-exposure, complex, and litigated claims involving serious injuries In this role, you will take ownership of the full claims lifecycle-from initial investigation through resolution-while managing litigation strategy and collaborating with defense counsel. Analyze auto claims to identify areas of dispute, investigating and gathering all necessary information and documentation, evaluating liability and damages and negotiating and resolving claims with opposing parties or their insurance providers.
Complex Claims Consultant/Specialist - Lawyers Professional Liability CNA Financial Corp.Complex Claims Consultant/Specialist - Lawyers Professional LiabilityLos Angeles, CA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex commercial claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
NewClaim Benefit Specialist CVS Health CorpClaim Benefit SpecialistCA$17–$25.65 / hourAnalyzes and approves rework claims that cannot be auto adjudicated.- In accordance with prescribed operational guidelines, manages claims on desk, route/queues, and ECHS within specified turn-around-time parameters (Electronic Correspondence Handling System-system used to process correspondence that is scanned in the system by a vendor). Utilizes all applicable system functions available ensuring accurate and timely claim processing service (i.e., utilizes Claim Check, reasonable and customary data, and other post-containment tools).
Senior Claims Examiner, Lawyers and Financial Advisors Professional Liability Markel Group IncSenior Claims Examiner, Lawyers and Financial Advisors Professional LiabilityWoodland Hills, CA$78,000–$134,090 / yearThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues.
Billing Specialist Developmental Pathways Inc.Billing SpecialistVan Nuys, CAIf you are an organized, detail-oriented professional with experience in healthcare or behavioral health billing, we encourage you to apply and make a difference with Developmental Pathways, Inc. #BillingJobs #HealthcareBilling #MedicalBilling #BehavioralHealth #ABABilling #VanNuysJobs #PartTimeJobs #InsuranceClaims #CaliforniaJobs. Our Administrative Support team members play a vital role in advancing our mission to make a difference in the lives of children with autism spectrum disorder and their families.
Claims Edit Coder Cedars-Sinai Medical CenterClaims Edit CoderLos Angeles, CAWhat you will be doing in this role: The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team. Communicates with physicians, providers, and external departments regarding documentation clarity, specificity, ensure the completeness of documentation required for code assignment within area(s) of assignment or specialty.
Appraisal Specialist Mercury Insurance CompanyAppraisal SpecialistCA$32,363–$56,701 / yearUpon completion of our comprehensive training program, and with ongoing guidance and support, the Appraisal Specialist takes the lead in researching vehicle values and negotiating total loss settlements accurately, efficiently and with excellent customer service. Essential Job Functions: Research actual cash value of vehicles by gathering and analyzing current market information to reach an equitable settlement of damages for losses due to theft and collision, while maintaining good customer service and shop relations.
Facility Outpatient Surgical and Claims Edit Auditor (Remote) Cedars-Sinai Medical CenterFacility Outpatient Surgical and Claims Edit Auditor (Remote)Los Angeles, CARemoteMaintains appropriate open communication with internal and external partners and peer departments such as Coding Operations, Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI). Auditors evaluate compliance with all coding guidelines including but not limited to: Internal Coding policies/procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State, and Federal Coding Guidelines.
Lien Collection Specialist ALIGN Executive SearchLien Collection SpecialistCosta Mesa, CAProficient in Microsoft Office and case management software (e.g., Clio, SmartAdvocate); able to manage high-volume caseloads. We're seeking a detail-oriented Lien Specialist with strong analytical skills and knowledge of healthcare, insurance, and legal lien reduction strategies.
Facility Inpatient Surgical and Claims Edit Auditor Cedars-Sinai Medical CenterFacility Inpatient Surgical and Claims Edit AuditorLos Angeles, CARemoteMaintains appropriate open communication with internal and external partners and peer departments such as Coding Operations, Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI). Auditors evaluate compliance with all coding guidelines including but not limited to: Internal Coding policies/procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State, and Federal Coding Guidelines.
Insurance Specialist (Remote) - Mountain and Pacific Time Zones MeduitInsurance Specialist (Remote) - Mountain and Pacific Time ZonesCaliforniaRemoteboth in-person and by telephone to register patients, gather or update information, obtain referrals and pre-authorizations, complete appropriate forms, conduct evaluations, determine benefits and eligibility (insurance, public programs, etc.), determine financial responsibility and/or to identify sources of payment for servicesâ¯. You will utilize your expertise in patient billing, claims submission, and payer guidelines (Medicare, Medicaid, &, commercial insurers) to effectively work with insurance companies, resolve issues, and ensure accurate and timely payments.
Revenue Cycle Specialist Behavioral Health Services IncRevenue Cycle SpecialistGardena, CACollaborate closely with other departments to contribute to cash reconciliation activities and to assist in the assessment of accounts receivable collectability and validation, including the writing off of bad debts. Includes all activities within the scope of the Billing & Accounting Departments including charge/ data entry, insurance follow up, and billing and collection of client balances.
Medical Billing & Coding Specialist OneOncology IncMedical Billing & Coding SpecialistCARemoteOneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve.
Regulatory Affairs Specialist Scale MediaRegulatory Affairs SpecialistBurbank, CARemote$75,000–$85,000 / yearPrepare and present industry updates at recurring team meetings (e.g., a monthly regulatory round-up), keeping cross-functional partners aware of what's happening and why it matters. Comfort with quality or product documentation basics — reviewing specifications or Certificates of Analysis (COAs) and meeting the documentation timelines that gate product release.
Utilization Management Nurse Specialist RN II L.A. Care Health PlanUtilization Management Nurse Specialist RN IILos Angeles, CAPerforms telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, member/family interaction to develop and implement a successful discharge plan. Receives incoming calls from providers, professionally handles complex calls, researches to identify timely and accurate resolution steps.
Customs Specialist C.H. Robinson Worldwide IncCustoms SpecialistLong Beach, CA$21.76–$45.96 / hourIn this role, you will serve as a trusted customs expert, managing complex exceptions, government agency examinations, and high-impact shipment issues while delivering exceptional service and operational excellence. Your individual base pay within this range is determined by work location, which takes into account geographic cost of labor, and additional factors, including job-related skills, experience, and relevant education or training.
NewSr. Denials & Appeals Specialist Baylor Miraca Genetics Laboratories LLCSr. Denials & Appeals SpecialistCAAny resumes submitted to Baylor Genetics in the absence of an Agreement executed by Baylor Genetics authorized signatory will be considered the property of Baylor Genetics, and Baylor Genetics will not be obligated to pay any associated recruitment fees. While we occasionally partner with select recruitment agencies for specialized roles, we do not accept unsolicited resumes from recruiters or agencies without a written agreement executed by the authorized signatory for Baylor Genetics ("Agreement").
[HVAC / CUSTOMER ADVOCACY] HVAC Technical and Field Support Specialist TCL Technology Group Corp[HVAC / CUSTOMER ADVOCACY] HVAC Technical and Field Support SpecialistIrvine, CA$75,000–$100,000 / yearThis role plays a critical part in elevating the customer and partner experience by resolving complex technical issues, strengthening field capabilities, and driving continuous product and service improvements across TCL''s HVAC and consumer electronics portfolio. As a key bridge between customers, field partners, and internal engineering teams, this individual will lead advanced troubleshooting efforts, support technical training initiatives, and contribute to root cause analysis and product feedback loops.